MS & Pregnancy – Answering All Your Questions!

Over the course of the last several months I’ve gotten lots of questions on the topic of MS and pregnancy so I wanted to take the opportunity to discuss this important – yet rarely openly talked about topic.
While I am just one person with my own unique set of circumstances, I know that my situation as a “thirty-something-year old-female wanting a family” is relatable and therefore, aim to be open and candid about my experiences as possible. It’s helpful for me to hear from others so I hope me sharing is helpful to you too (let me know if the comments section!).
IMPORTANT : I want to make it clear that I’m not a medical professional and am NOT offering medical advice. My answers are based on my personal experience, my neurologist’s advice and the extensive research I’ve done over the years. Brief Synopsis of my Condition Diagnosed : January 2015 – 4+ years ago Symptoms : Sensory and vision only with one bout of optic neuritis Lesions : 20+ lesions in my brain; none in my spine as of 1/15 but getting re-checked for both in 5/19 (hence no physical symptoms) Medication : Tysabri, once a month IV infusion (not when pregnant) Neurologist : Dr. Dusan Stefoski from Rush University Medical Center in Chicago All questions below were submitted by my Instagram followers or emailed to me directly so I wanted to include them in a Q&A format to be as straightforward and specific as possible. Okay… now onto the good stuff. Let’s talk pregnancy! When are you supposed to get off of a medication if you’re trying to conceive or are pregnant?
This question is highly debated and you will hear different answers depending on which neurologist you talk to. Some say to stop meds 3 months in advance of becoming pregnant since it takes a while for the drugs to get out of your system, others say you should stop when you learn you are pregnant and now, some doctors say that you can continue certain medications during pregnancy (although this is rare).
What I’ve gathered is that every situation is unique and based on your own medical condition. You need to see if the benefits outweigh the risks of being without meds. If you’re someone who has noticeable symptoms that affect your quality of life, then yes, your doctor may recommend you stay on medication longer or continue during pregnancy. It depends on you and how you’re doing. But quite predictably, no one can say for certain how these powerful meds can affect a growing fetus so it’s safer to get off of medication as quickly as you can. Ultimately, you need to balance what’s safest for you and the baby and go from there.
For me, I stopped doing Tysabri once I got a positive pregnancy test. Because it took us so long to conceive and we had to undergo IVF, my doctors didn’t want me off a medication during that period. So we agreed the best compromise was to stop once pregnant and to resume immediately after giving birth. What are the potential risks of getting pregnant with MS?
Being pregnant means that you’re without medication which puts you at a higher risk for a flare up or relapse. While many doctors actually say you’re typically “protected” from these flares during pregnancy, it’s been scientifically proven that your chance of relapse within the first 6 months of giving birth goes up significantly – up 40% according to the National MS Society. In fact, post-pregnancy is when many women learn of their MS diagnosis as their symptoms have been mostly dormant and then flare up with hormonal changes post-pregnancy. Is there anything you can do to minimize your chance of a relapse?
In my experience, yes. Two things: Begin your meds up immediately – Based on the medication you choose, you are decreasing the likelihood of a relapse by 25-60% (every medication has its own efficacy levels). But, medications rarely start working immediately and usually take 3-6 months to get back into your system. IVF steroids in the short term – Since medications are not immediately effective, many neurologists will recommend Prednisone – or some kind of IV steroid – to compress your immune system following giving birth. I completed a 5-day IV dose of Prednisone beginning the day I delivered my daughter, Chloe, and thankfully did not have a relapse. I will do this again in a few weeks after I give birth. This photo was taken the day I gave birth to Chloe while I was undergoing steroids via IV. Gotta do what you gotta do!
Steroids helped in the short term and also allowed me a 3-month period to breastfeed since that was important to me. I was told that one 5-day dose of steroids would “protect” me for up to 3 months and would not harm my daughter when breastfeeding.
Steroids result in bloating, mood swings, feeling jittery and sleeplessness so I definitely wouldn’t recommend them as a “fix”. How long do steroids last / how many doses of steroids can you do?
Steroids are intended for short-term use only – whether you’re using as a fix for a flare up or short-term protection. My doctor advised not to do more than two doses in a row (so “coverage” for 6 months or once every three months) as my body would become immune to it and they would no longer be effective. Did your MS symptoms act up during pregnancy?
NO! I felt great from an MS perspective – with both Chloe and baby boy.
In most cases, like mine, MS symptoms are dormant during pregnancy and you’re actually supposed to be “protected” for 9 months. Pretty amazing, right?
While pregnant with Chloe I did get two new lesions on my brain but they were not activated and therefore, I luckily didn’t get any symptoms. I plan to get an MRI after I deliver baby boy so I’ll let you know the results.
While MS dormancy is typically the case, I’ve definitely heard of people having a relapse or flare during pregnancy although it’s rare. How did you and your neurologist decide on your treatment post-pregnancy?
The goal for us has always been to 1) minimize my symptoms and 2) reduce the likelihood of my MS progressing – all while weighing the consequences of the medicinal risks.
We ultimately decided on Tysabri after my diagnosis 3 years ago because we wanted to essentially ‘stop MS in its tracks’. I had 20+ lesions that had been there for a while and were never treated so we needed to use the most effective drug at the time to control it. Tysabri, however, comes with some scary side effects including PML (a deadly brain disease). This is terrifying but the risk of obtaining PM is so low to me (I am not JVC positive), so the benefits of the drug outweighed the possible consequences.
Now, 4 years and two babies later, there are other very effective options on the market – some of which are more convenient and possibly “better”. BUT we choose to continue on Tysabri because my body tolerated it very well (no relapses!) and I am still JVC negative. (If you’re positive, you still have two years to safely be on this medication but you need to go in for continuous blood testing as this can result in PML). So our thought process really was – “why mess with something that’s working?” Are there any “safe” medications for breastfeeding or trying to conceive?
I was told Copaxone – which is administered as a shot – was the “safest” for trying to conceive and even breastfeeding. However, the efficacy levels were so much lower than my current medication (Tysabri) that I decided against it. I would recommend asking your doctor for the latest and most update to date research on this. Did you breastfeed? Why or why not?
As a first time mom, it was important to me to breastfeed my daughter but I knew that that decision came with risks since you’d be off medication and at a higher chance of relapse post-birth. My neurologist and I compromised that I would only breastfeed for 3 months before I started on Tysabri, and undergo a 5-day dose of steroids immediately following her birth to protect me during that period. You can read about my breastfeeding experience with a Chloe here .
This time around I will not attempt to breastfeed for concern for myself and ultimately for my children. The risks are simply too high and my priority is to minimize my chance of relapse. I need to be my best physically and mentally to take care of my family.
Luckily, and quite unexpectedly, my cousin offered me her over-supply of breastmilk that she typically donates to a NICU clinic. Since baby boy will be only 34 weeks at birth and subsequently in the NICU, I graciously accepted her generous offer. Since premature babies haven’t had the ability to develop the same antibodies as full-term babies, I want to give our son the milk that has been proven to provide those. Huge thanks to you, TR. What’s your plan post-birth?
Immediately following baby boy’s birth, I will undergo 5 days of steroids again to try to avoid a relapse and then resume Tysabri within days of delivering. Need to get back on track and hopefully avoid a relapse. Any problems with undergoing IVF with MS?
I was super concerned about this but the direct impact wasn’t as bad as I thought.
To be honest, my biggest MS stressor is STRESS so when I feel stress, my body reacts. Undergoing IVF and dealing with infertility problems was by far and away the most difficult thing I’ve experienced and quite honestly, I’ve never felt worse mentally or physically. It just drains you (with or without MS!) so adding in that additional factor was hard. My body would often get numb – my arms and my hands – and I’d experience tingles all over. Fatigue and cloudiness (brain fog) were common too.
From a direct medication stand point, the only thing I couldn’t be on was Clomid – a common fertility medication to increase your likelihood of conceiving – so instead I opted for Letrizole. Ask your doctor about this too as it was a great alternative (even though it didn’t work for us).
In terms of the actual shots, retrieval or transfer process, NOTHING changes with MS and I wasn’t impacted. I was able to continue my monthly infusions of Tysabri during the entire process as well. Does MS affect your ability to conceive?
Well, this question is highly debated and i dont l think there is a concrete answer.
As discussed in my IVF series which you can start reading about here , my fertility doctor told me quite definitively that my MS had deteriorated the quality of my eggs. He said they had “aged” the equivalent of roughly 10 years (so I am 34 and said my egg quality was that of a 40-something year old) making it even harder for me to get and stay pregnant. Some people will question the truth behind the correlation and say there are no concrete studies to prove this theory – and I don’t claim to have physical evidence of this – but I will say that my IVF experience aligned with his theory. Let me explain.
During my egg retrieval, we got 12 eggs (a pretty decent amount) but of those 12 – 8 of which made it to 5-day embryos – only 3 (!!!!) were viable. That means that 5 of our fully developed embryos had a chromosomal abnormality and wouldn’t result in a healthy or normal child. At my age, that number should have been closer to 20% – not 60%. This aligns exactly with the results of someone in their mid-forties, not thirties. Did your neurologist recommend that you freeze your eggs after your diagnosis?
No, but I wish he did.
(Before I elaborate, I want to point out that I’m by nature a Type-A planner that doesn’t like “taking things as they come”. I prefer to be calculated and reduce the pressure, but this definitely doesn’t mean you should! It’s a matter of YOUR comfort level – not mine.)
Okay, this question goes back to whether MS affects fertility but it also has to do with general life pressure and stresses. The truth is, if you’re not in a rush to have babies but know you want to some day, I say FREEZE YOUR EGGS! Why put unneeded stress on your self if you have the ability (and financial capability) to do this? Is minimally explore the process and cost with a fertility clinic (why not learn more?). Whether I had MS or not, I – as anyone! – was most fertile in my twenties and as I aged the number and quality of my eggs went down significantly. It’s not to say that you CAN’T get pregnant but the likelihood of getting pregnancy as easily or quickly is significantly reduced. As you age, the quality of your eggs deteriorate which is why miscarriage rates are so high nowadays. People are getting pregnant later in life and some of the viable eggs are missing chromosomes or are blatantly abnormal which will not lead to a normal pregnancy.
My best advice would be to look at your situation holistically – based on your goals, short term and longer term, your financial situation and personality type / comfort level – and figure out what’s best for you. Only you can make that call. Ok, well that’s it! I hope you found this helpful. If you have any other questions you can reach out directly.
— Do you know of someone with MS that’s considering conceiving or currently pregnant? Please forward them this email or sign them up for my blog here – subscribe on the sidebar. They can also follow me on Instagram here where I often elaborate on my MS journey. I’ve found that being apart of this MS community, sharing information, experiences and learning from others has been incredibly helpful and gotten me through my diagnosis. I know many others who share this sentiment so please share. Follow along!

What You Need to Know About Kennel Cough

Close search bar What You Need to Know About Kennel Cough
Kennel cough in dogs isn’t usually a grave condition — in most cases, your vet can help you tackle this disease and get your dog back to their optimum state of health. Mar 19, 2019 March 18, 2019 Dogs can contract kennel cough not just at kennels but also at dog parks, veterinary offices and pet stores. Photo: PIX1861
Kennel cough, an infectious canine cough caused by either a virus or a bacteria, is a term familiar to most dog lovers.
Folks coined the name “kennel cough” because dogs are most susceptible to contracting this infectious cough in a high-stress, densely populated canine environment — such as a dog kennel. Today, kennel cough falls under the umbrella name of canine infectious respiratory disease complex (CIRDC).
Many folks hear “kennel cough” and believe their dog will never get this annoying cough if they never go near a kennel. ADVERTISEMENT
This is not t rue. Dogs can contract an infectious cough almost anywhere, although exposure to another dog with an infectious cough is the most likely and obvious way your dog will contract this cough. How Is Kennel Cough Contracted?
Dog-to-dog contact is the most common mode of transmission. Here are some places your dog might contract kennel cough: Pet shops Canine sporting or showing events Veterinary hospitals
Your dog catching kennel cough is similar to how little kids contract cold after cold in school, daycare, playgrounds or the pediatrician’s office.
The cough can also be spread in the air and environment. A dog can contract a cough from aerosolized secretions and surfaces. Think of the common cold again. You just don’t always know where you got that annoying respiratory sneeze, runny nose or cough. The cause of kennel cough can be viral or bacterial. Photo: Incredibull–Photos Symptoms of Kennel Cough
A honking cough is the most obvious sign of kennel cough. Other symptoms you may see include: A cough that sounds like the dog has something caught in their throat Sneezing or a runny nose Runny eyes A gagging, retching cough that might be misinterpreted as an attempt to vomit
Although most dogs remain bright and alert, some can certainly become lethargic or lose their appetite if they’ve been up all night coughing, heaving, retching or running a low-grade fever.
In the veterinary exam, a telltale sign that we have a kennel cough problem is an easily induced cough. By gently palpating my patient’s trachea, I can usually make the dog with kennel cough start coughing right away, and the client invariably says, “That’s it!” ADVERTISEMENT
Although kennel cough is not considered a very serious disease, it can be worrisome or get very serious in certain cases.
Puppies are more susceptible to kennel cough. They are often not vaccinated and have immature immune systems. Tiny puppies are at risk for developing serious upper respiratory signs and/or pneumonia. Puppies housed in pet stores or puppies being transported are more susceptible to kennel cough.
Unvaccinated dogs are, of course, more susceptible to kennel cough and can develop a more severe cough of longer duration compared with their vaccinated counterparts.
Brachycephalic dogs, older dogs and dogs with other respiratory diseases can become sicker if they contract kennel cough. Treatment of Kennel Cough
To treat or not to treat? That is the question.
When you get a cold, you realize it is self-limiting, probably reach for over-the-counter (OTC) remedies for symptomatic relief when necessary and go to the doctor only when it’s not going away and the symptoms are worsening.
Kennel cough follows a similar path. Was YOUR Pet Food Recalled? CHECK RECALLS NOW! Case #1
Many “self-limiting” cases of kennel cough last for about a week. People often call the vet and describe a mild to moderate cough that happens 3 to 4 times a day, and their vet will suggest that the symptoms sound like kennel cough.
If the client isn’t overly concerned and the patient is happily running around and not terribly bothered by this cough, many vets will say an appointment isn’t absolutely necessary unless symptoms become worse or prolonged. Case #2
A client calls the vet and describes a honking cough that’s been going on for several days and seems to be getting worse. They might even hold the phone up to their dog so I can hear the foghorn blasting away!
The client sounds concerned, and the dog clearly has a more serious case of kennel cough. Although this cough might still go away in a few more days, this pup should most definitely come in to the vet and get some help. Kennel cough can be very serious for puppies, so don’t hesitate to see the vet if you suspect your young dog has it. Photo: pixabay What You Can Do at Home Before Going to the Vet Cough Suppressants
Your vet may suggest OTC cough suppressants. You can use a product like Robitussin DM for 1–2 days and see if it helps.
Ask your vet for specific dosing instructions and even a written prescription to show the pharmacist. I’ve had lots of clients go to the drugstore, get confused by the 50 different cough medications on the shelf and pick the wrong one.
Know that it’s controversial whether OTC cough suppressants really work or not. ADVERTISEMENT Lifestyle Changes
Lifestyle changes can help reduce coughing. Try to remove any barking triggers — barking and excitement make the cough worse. Limiting exercise and excessive play for a week can help. If the mailman triggers your dog to bark or you have one of those couch surfers who stands on the cushions and barks at kids on bicycles, remove these triggers. Exchange your leash for a harness until the cough goes away. Anything that pulls on your dog’s throat (trachea) can start or aggravate the coughing. Since your dog is contagious at this point in the kennel cough cycle, curtail leash walks completely if at all possible so your dog does not pull on its throat and you’re not exposing other dogs to your little coughing machine. Respiratory irritants, such as cigarette smoke, should be avoided in the environment. The Vet Visit for Kennel Cough
I see many cases of kennel cough. Here are a few scenarios. The cough is getting worse, is going on for more than several days or got better and came back (called refractory). The dog is “sick,” meaning lethargy, lack of appetite, etc. The client is very concerned and either the dog or the client can’t sleep at night. The patient might be more fragile than the average dog. Puppies, shelter adoptions, brachycephalic breeds , dogs with other respiratory diseases and dogs with other concurrent diseases can become very sick from kennel cough.
There is no simple “test” for kennel cough; treatment and diagnostics differ in every case. Your vet usually makes a tentative diagnoses based on observation, the history and an easily elicited cough on tracheal palpation.
The classic case is the dog who develops a cough after being boarded or being recently adopted from a shelter or pet store. We often don’t know whether we are treating a viral kennel cough, a bacterial kennel cough or a mixed infection.
Blood work, specific viral or bacterial testing, and/or X-rays are indicated for more complicated or refractory cases.
Listen to this dog’s honking kennel cough: Medications for Kennel Cough
Here’s a list of drugs prescribed most frequently in cases of kennel cough: Antibiotics
Doxycyline is effective in lessening the cough and upper respiratory signs of bacterial kennel cough. Perhaps doxy helps viral kennel cough cases with anti-inflammatory effects.
Some dogs cannot tolerate doxycycline, and some cases of kennel cough respond to a different or additional antibiotic to treat the cough or pneumonia. Well-known antibiotics — such as Clavamox, the cephalosporins (Keflex), sulfa antibiotics or a fluoroquinolone, like ciprofloxacin — may help the coughing dog with a deep bacterial infection. Cough Suppressants
Veterinarians often prescribe cough suppressants with a small amount of narcotic in them for a more serious cough.
Some vets are becoming more reluctant to prescribe these or will give you a prescription to have filled elsewhere because of the opioid epidemic and problems associated with prescribing and keeping records of controlled substances. Prednisone
This is a steroid, sometimes used as an anti-inflammatory for certain coughs. It is also in a combination veterinary drug used to suppress coughs called Temaril-P.
Whenever vets prescribe prednisone, it must be done with caution and a full knowledge of the patient’s health status. The use of prednisone is controversial, and it’s usually never used as a first-line drug for kennel cough. Cerenia (Maropitant)
A fairly new veterinary drug, Cerenia helps curtail vomiting and stop the symptoms of car sickness. It can also help dry up secretions in a coughing dog.
Some dogs with kennel cough have prolonged symptoms, particularly puppies or dogs who have been housed in shelters and may have had kennel cough for a long time, or if the cough is refractory.
If these cases don’t respond to the classic drug therapy, I will reach for Cerenia; it often helps a lot. Brachycephalic dogs, such as French Bulldogs and Pugs, may become sicker than most other dogs if they contract kennel cough. Photo: pixabay Prevention of Kennel Cough
The “kennel cough” vaccine (Bordetella) is safe and administered as an oral, intranasal or injectable vaccine that’s quite effective against one of the leading causes of bacterial kennel cough.
The DHLPP vaccine covers some of the viral causes of kennel cough. Even though a vaccinated dog can still contract a case of kennel cough, the symptoms and duration are usually much less severe than a kennel cough infection in an unvaccinated dog.
The take-home message is that kennel cough isn’t usually a serious disease, although it is annoying, contagious and can become serious in certain cases. Your vet can help your coughing dog if the cough doesn’t go away in a few days. You can do a lot to prevent it by simply keeping your dog up to date on the DHLPP and Bordetella vaccinations. References Ford, R. B. Infectious Diseases of the Dog and Cat , 4th ed. Elsevier. 2012. Lappin, M. R., et al. “Antimicrobial Use Guidelines for Treatment of Respiratory Diseases in Dogs and Cats.” Journal of Veterinary Internal Medicine 31, no. 2 (March 2017): 279–294. Lister, A. “Canine Infectious Respiratory Disease Complex (CIRDC).” Atlantic Coast Veterinary Conference. 2015. This pet health content was written by a veterinarian, Dr. Debora Lichtenberg, VMD . It was last reviewed March 19, 2019. ADVERTISEMENT

ASTRONAUTS NEAR MEDICAL RELEASE; But Will Remain in Hawaii 10 Days for Observation

HONOLULU, July 27 The Apollo astronauts will be released from Tripler Army Medical Center within 48 hours, but will stay in Hawaii for about 10 days for rest and medical observation, doctors said tonight.

VCA Animal Hospital

by Zachery Clem on 4 minutes ago 2 views Talk to a doctor right away if you notice stress, irritability, aggression, or any other uncommon behaviors. Take this medication orally, with or without food, usually once every day, or as directed by your physician. Often there are too few people doing work in an emerging occupation to gather study information. Prednisone (and Prednisolone, we will talk about the difference in just a bit) are FDA approved steroids which are used to reduce inflammation in the body plus treat a handful of diseases and ailments, both for pets and people alike. Because of the drug’s ability to reduce immune system responses, they are also used to manage allergic reactions and autoimmune conditions like lupus and AIHA. You can understand these queries as people love their canines. 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For instance , if a patient comes in seeking suggestions and is just in the beginning stages associated with losing hair, we may recommend Propecia (finasteride), Rogaine (minoxidil) and/or laserlight therapy Women who do touch the dutasteride capsule or a finasteride capsule should wash their hands instantly with soap and water. Stick to the prescribed given by your vet, and you will see no issues. Follow your own veterinarian’s dosage guidelines and get in touch with your vet if you see indications of any serious symptoms. Following the service, we will have a Homecoming Wedding reception that will feature tasty items through all the food groups! It is possible that these symptoms might continue or increase until the complete anti-depressant effect of your medicine turns into apparent (i. This item is going to be shipped through the Global Shipping Plan and includes international tracking. 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Whenever Will The NEXIUM Patents Run out, And When Will Generic NEXIUM Start?

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Prednisone and prednisolone deal with a wide variety of diseases and disorders within dogs and can be prescribed simply by veterinarians for many conditions, often as additional treatment. Prednisone (and Prednisolone, we will talk about the difference in just a bit) are FDA approved steroids which are used to reduce inflammation in the body plus treat a handful of diseases and ailments, both for pets and people alike. Because of the drug’s ability to reduce immune system responses, they are also used to manage allergic reactions and autoimmune conditions for example lupus and AIHA. If it is almost time for your following dose, skip the dose a person missed and take your next dosage when you are meant to. Weight loss can be desired in diabetic patients to help manage glucose levels and improve insulin resistance. Often there are too few people doing work in an emerging occupation to gather study information. Generally, daily use for 3 months or even more may be necessary before you notice improved hair growth or prevention of more loss Take this medication orally, with or without food, usually once day-to-day, or as directed by your physician. You can understand these queries as people love their canines. Advair can raise the blood strain and pulse charge because of the lengthy acting bronchodilator in it. What other medicines can be utilized to deal with the symptoms of PCOS? Metronidazole can be used to deal with inside abscesses or inflammatory bowel illness. That’s as a result of plenty of weekend warriors depend on ibuprofen and different non steroidal anti-inflammatory medicine (NSAIDs) to relieve inflammation and pain. It has been identified to cause other results like insomnia, or muscle pain. By definition, women with PCOS don’t spontaneously ovulate each month such that fertility therapies, specifically, ovulation induction, is usually required for conception. 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Reality Check (Crohn’s and IVF Update 3/15)

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It has been a long week full of reality checks, set backs, and also some good progress. I’ll get you caught up particularly with regards to my Crohn’s flare and what it means for IVF.
The last catch up was about the beginning of my flare and the onset of my illness. Crohn’s Flare Update
Last we spoke, I had just had my colonoscopy/endoscopy. To recap, we found some active inflammation and ulcers as a result of reflux. Friday was a semi-ok day–I really don’t remember a ton of it, actually, which means it was neither good nor bad. I know I spent a decent amount of time in the bathroom, but mostly in the morning. Alex had clinic, so I was on my own. I picked up my steroid (Uceris) and I went to Strides to see my friends, but I didn’t participate. Like I said, the day was ok. I got my Tarascas.
Saturday, barring a bit of a rough start that morning, I felt like I was making progress. We went to swim, I took a nap, we had family time. I was tired, but I was ok.
Sunday is when things fell apart. I spent the whole day exhausted and in and out of the bathroom (8x). We had brunch and did grocery shopping, but I was kind of just making it through. Seeing enough blood + my exhaustion + the amoutn of tiem I spent in the bathroom meant that Alex contacted my doctor (who happens to be his colleague, fortunately), and they decided that I needed to go on a more pervasive and harder core steroid–Prednisone.
The prednisone gave me back my ME. For 12 hours, I felt so much better. I had energy again, I didn’t go to the bathroom. Thanks to Alex’s urging and the new influx of health-feeling, I went to strides. I scaled the workout and took it easy, but I made it through and doing so gave me a lot of confidence back. Plus it felt good to be with friends and move my body. Even if I looked like death doing it, I no longer felt like death afterwards. We even went to the Nature Museum after so that Emmie could run around, and I finally was able to play with her and actually interact, rather than just letting Alex do everything. I made chili for Alex’s lunches for the next few days. I made enchiladas from scratch for dinner.
And then, 12 hours after I had taken the steroid, my got reminded that I am not out of the woods. And the floor fell out from underneath me. Back to the bathroom. Here come the cramps (unlike many other flares, the cramps this time have been rather minor. Mostly I’ve been dealing with urgency).
Tuesday I headed down to the hospital early to have labs drawn before Remicade, I got my infusion, and then I saw my doctor. Originally, this appointment was supposed to be a Well Child visit of sorts. Not so much.
I am so fortunate with my doctor. Even when/if she wasn’t working with Alex (she didn’t work with him the first years we were here), I just think she is an excellent doctor. Add to the fact that she knows Alex and she knows as well our infertility journey and the fact that we were about to try for another, and she had to make some tough decisions. But the right decisions.
First off, we are increasing the dosage of my Remicade infusion and shortening the interval/# of weeks between infusions. That is a pretty standard reaction, especially due to the fact that I weigh more now than I did before I was pregnant and am now in a flare.
Next, we are going to do IV iron because I have iron deficient anemia. As the inflammation in my body goes down, I should become less anemic. The low level of iron in my body (I’m not in a bad bad way, but it is trending that way) and my tendency towards constipation plus all the nonsense and absorption issues that go along with flares = do IV iron so that you can still go to the bathroom and also actually absorb the iron.
We can expect me to be on the Prednisone for about 2 months, best case scenario. That is because you need to be “perfect” on each dosage before you go down, and the nature of prednisone is that you go down by 5 mg until you get to 20 mg and then 2.5 mg a weekish after that.
I hate prednisone. It makes me crazy, makes me gain weight, and I have really, really bad mental associations with it. But if it can get me back my life, I need it. I will have to be more careful, bones-wise, as this is another bone-tapping drug.
The biggest change, however, will be the return of Methotrexate to my drug regimen. You may or may not remember, but Methotrexate is a weekly injection that I used to give myself. Its job as an immunomodulator is to tell my immune system to chill out and allow Remicade to do its work without having to fight antibodies. It also helps my skin, which has never been the same since I went off of it 3 years ago. IVF Update
The problem? You cannot be on Mtx and get pregnant. In fact, it is one of the original abortion drugs and a cancer treatment drug. I can expect to be on it a minimum of 6 months, best case scenario. Then I have to wait 3 months after stopping it, have a colonscopy, and then I can get the go ahead to start IVF.
So, at best, I will be able to start another egg retrieval cycle mid/end December. And that is if we anticipate everything and start treatment basically the day after my colonoscopy.
I left the appointment really, really bummed. I just hadn’t thought or wanted to think or believe that I was that sick, or that I had that much potential to get more sick. The two months of prednisone sucks. I hate being on steroids. I don’t care about giving myself a shot-I would be doing that around now if all had gone accoring to plan! But the 9 month minimum means that we will have 5 months to try to get pregnant (we have to before the end of Alex’s fellowship).
But I have to be healthy in order to even think about getting pregnant. Thank goodness we weren’t already in the middle of a retrieval cycle! I need to be healthy to be a good mommy, to have my best life. I was already lucky enough to have my little unicorn, and we started IVF on NYE and got pregnant with Emmie May 7, so miracles can happen in 5 months!
The process has been delayed, not aborted. At least that’s what I keep telling myself.

A Child’s Fight for Life: Parents vs. Doctors; HEALTH

Do parents have the right to refuse medical treatment for their children? This provocative question is being raised by a case now wending its way through the courts in Massachusetts. On one side are Gerald and Diana Green, a young couple of Scitua…

Medical News Today: What to know about psoriatic spondylitis

Not every person who has psoriatic spondylitis will experience these complications. The best way to prevent complications occurring is to receive prompt treatment and follow a doctor’s recommendations. Diagnosis
The NPF website has an online quiz that people can do to help them work out whether they may have psoriatic arthritis. Anyone who thinks they may have the condition can visit their doctor to find out more.
Initially, a doctor may ask the person to fill out a screening tool for psoriatic arthritis .
They may also use a variety of other tests to determine whether a person has psoriatic spondylitis. Firstly, they rule out other types of arthritis and other causes of back pain. This is important because treatment for psoriatic spondylitis and other types of arthritis are different.
Along with joint-related symptoms, a doctor may also look for signs of psoriasis, such as silvery scales on the skin and pitted or crumbling nails.
Doctors may also use imaging tests, such as X-rays, MRI scans , ultrasounds , and CT scans to look at the bones and joints in the spine.
Doctors also do blood tests to help diagnose psoriatic spondylitis because people with this condition can have high levels of inflammation in the blood. People who have psoriatic spondylitis also may have lower red blood cell counts.
Doctors can use blood tests to rule out other forms of arthritis. Treatments
Psoriatic spondylitis symptoms can be difficult and painful, but doctors can treat the condition.
The aim of treatment for psoriatic spondylitis treatment is to prevent damage to the bones and joints, help a person manage symptoms, and achieve remission. Remission means a person has no symptoms and the disease is not getting worse.
However, people will need to use medications long-term to stay symptom-free.
A variety of medications are available to treat psoriatic spondylitis, including: Anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs ( NSAIDs ) can help relieve mild psoriatic spondylitis pain, reduce inflammation, and relieve stiffness. However, NSAIDs can have side effects, such as stomach bleeding and kidney impairment, especially when a person takes them for long periods. Talk to a doctor about how to use NSAIDs safely.
NSAIDs include ibuprofen, naproxen, and aspirin , as well as prescription options. Disease-modifying antirheumatic drugs
Disease-modifying antirheumatic drugs (DMARDs) control inflammation or the body’s overactive immune response. They can help relieve symptoms of psoriatic spondylitis and prevent damage to joints. A person may take them as a pill or get an injection.
DMARDs include the following classes of drugs: drugs that suppress the immune system response, such as methotrexate, azathioprine, leflunomide, and cyclosporine drugs that control inflammation in the body, including sulfasalazine and acthar therapy biologics, which target specific immune cells to reduce inflammation Biologics
Biologics are a newer, more targeted therapy than DMARDs. Doctors administer this medicine through injections. Biologics work by interfering with natural immune pathways, mimicking the natural molecules, and reducing inflammation.
Biologics include: alpha (TNF) inhibitors, including etanercept , adalimumab , and infliximab T-cell inhibitors, such as abatacept other inhibitors target specific inflammatory proteins, such as ustekinumab, secukinumab, and ixekizumab
Not everyone will need biologics as a primary treatment. Biologics may increase a person’s risk of infection or cause specific side effects, such as flu-like symptoms or airway infections. Rarely, they can cause blood disorders, cancer, and other autoimmune symptoms. Talk to a doctor about the benefits, risks, and costs of biologics. Corticosteroids
Corticosteroids are powerful anti-inflammatory drugs. A person may take a corticosteroid pill such as prednisone, or a doctor may inject the medicine directly into the affected joint. These can provide short-term relief.
Doctors usually prescribe corticosteroids to treat severe severe flares until other medication, such as biologics or DMARDs, start to work.
Corticosteroid medication can have side effects that include weight gain, osteoporosis, and high blood pressure . Psoriasis may flare up when a person stops using steroids. Small molecule medications
Small molecule medications stop certain immune molecules from attacking the joints and skin. They include: apremilast tofacitinib Physical therapy
Exercise helps lessen the inflammation around the joints and helps to relieve pain. Stronger muscles also help support the joints, putting less stress on them.
A physical therapist can recommend specific stretches and exercises to help a person who has psoriatic spondylitis. An occupational therapist can recommend ways that a person can prevent joint stress and suggest how they can adapt their work environment to reduce pain and injury.
Some home remedies may also be useful for milder cases. Natural remedies Partaking in low-impact exercise, such as biking, can help keep joints flexible.
Using home remedies for psoriatic spondylitis can help ease symptoms. These remedies work alongside a doctor’s treatment plan. Follow a doctor’s advice on medications or other treatments to avoid future bone and joint damage.
The following natural and home remedies may help a person manage their psoriatic spondylitis: Exercise. Being active can help keep joints flexible. It can also help people maintain a healthful weight, which can take pressure off painful joints. Exercise boosts endorphins, which may help improve a person’s emotional well-being. Walking, biking, yoga , and Tai Chi are good low-impact choices. Some people find swimming to be easier on painful joints. Follow a regular sleep schedule. Fatigue can make psoriatic spondylitis symptoms feel worse. It can also trigger more Focus on getting enough sleep and maintaining a regular bedtime. Know the triggers. Keep a journal with foods, activities, and life events and write down when the psoriatic spondylitis gets worse. This can help identify the causes of flares so that people can avoid them in the future. Try acupuncture. A recent meta-analysis found that acupuncture was an effective option for reducing chronic musculoskeletal pain. Get a massage. A licensed massage therapist may use a variety of techniques to relieve tension and loosen stiff joints. Make sure the massage therapist has experience in treating spondylitis or arthritis. Eat an anti-inflammatory diet. Nutritious whole foods can help fight fatigue. A Mediterranean Diet can help fight inflammation. Learn more about anti-inflammatory foods here . Limit or avoid alcohol. Drinking alcohol may interfere with medications a person takes for psoriatic spondylitis and may cause unwanted side effects. Quit smoking. Smoking makes the symptoms of psoriatic arthritis worse. Quitting smoking can have a wide range of health benefits alongside relieving joint pain. Try hot or cold therapy. Some people find relief from the pain by using heating pads or cold packs on sore areas. Take periodic breaks to avoid burning the skin or getting frostbite . Manage stress. High stress levels can make psoriatic spondylitis symptoms worse. Summary
Many people find the symptoms of psoriatic spondylitis challenging, but with the variety of treatments available today, many people can manage their symptoms, prevent further joint damage, and carry out normal activities.
While there is no cure for psoriatic spondylitis, a person can keep symptoms under control with the help and guidance of their healthcare team. Following an effective treatment plan can help spondylitis lead healthy and active lives. Related coverage